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APPLICATI(;W FOR CONSTRUCT 'JN PERMIT 4TO BE COMPLETED IN INK —PLEASE PRINT <br />it, F.Ynrpnron <br />CITY 01' <br />everett HEATING SYSTEM: GAS O ELECTRIC O _ <br />BUILDING DEPARTMENT <br />259-8810 <br />/DEMOLITION I I COMBINATION I I QUILDING I I MECHANICAL <br />I��A�DQ�S� C I DG -c�C� .�l L25E ;� U I P <br />I ,,� ^ M n l MAK ADQ SS CITY IIP PHONE <br />EKI DESCNER �MAIL CITY I'll <br />IJ PLUMBING I I SIGN <br />)2 — %2r-) 5) — -;?/)6? <br />PLUMBI G CONTRACIOn MAR ADDRESS CITY ZIP PHONE LICENSE E <br />CLASS OF'YORK , , „ ,,,,� I I ncunl Innis I I WMngTOVFNFRPL INSERT ❑ BUILDING RELOCATION <br />— _ __ <br />CONTACT PERSON AND PHONE NO <br />© 00 <br />CON111ACT PFIICEOFVIOnK _ <br />I <br />BFSCIiIBC IVORK ID SOl1A�E F IE INVOlVEO <br />C IY VI �I. 1fJ1' <br />1 r <br />. <br />rROPOSED USE OTn,"" <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />FV�APPLICAI <br />ION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESGRIPUCN OF rnorenrY (SHOWN BELOW On ATTACH FOURCOPIESI <br />OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOt BLOCK <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />" <br />SKiNAT RE OF CONTBACIOR OR AUTHORIZED AGENT DATE <br />PnUJFCI ADDnES�/'Y A� / <br />�=�Sj <br />Ap L,CANIS GITV SS LICEN .F. NO ANPLUMBING__``// <br />�1 — <br />MECHANICAL <br />FEE <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT <br />WATER CLOSET (TOILET) <br />_ <br />NC—NHNDLG UNITS—H.P. <br />_ <br />FORCED AIR SYSTEMS—B.T.U. b E.A. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M _ <br />' <br />_ <br />SHOWER <br />' <br />CLOTHES DRYERS <br />KITCHEN SINK 6 DISP <br />' <br />VENTILATION FAN <br />— <br />DISHWASHER <br />�— <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />I <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />_ <br />' <br />METAL FIREPLACE A CHIMNEY <br />' <br />URINAL <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />' <br />HEAf PUMP <br />BACKFLOW PREVENTERS <br />i <br />OAS PIPING <br />_T-- <br />ROOF DRAINS—RAINLEADERS <br />' <br />EXHAUST FAN <br />' <br />SINK (SERVICE —BAR. ETC.) <br />i <br />I <br />� <br />1 <br />SUB TOTAL $ <br />i <br />SUB TOTAL $ <br />PERMIT S <br />I <br />PERMIT E <br />I <br />-- <br />- TOTAL FEE $1 <br />TOTAL FEE $ <br />7- <br />FOR OFFICE USE <br />iROf/I SETBACK <br />'' <br />USE ZONE <br />I IYM d CENTS ALIOWABIE <br />SIZE OF BLDG <br />I <br />ONLY: <br />REAR SETBACK <br />---- <br />LOT AREA <br />SIDE SE70ACK <br />PLAN CHECK NI1MDEn <br />of <br />nrcrml No <br />VACANT SIfE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />i <br />_ <br />TYPE d CONSI ACTUAL <br />oLMIABtl <br />01°'R <br />BO 11MUW W" <br />PI UMBING <br />I <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />I <br />-.-- <br />OCCUPANCY LOAD TIRE SPRNNlE05 REUV HEIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />OTHER <br />STATE BUILDING SURCHARGE <br />r6uC WORKS <br />u <br />WAKE BY <br />fRAN9 APPIKLVED BY <br />CITY OF EVERETT <br />l LOCAL SALES <br />I TAX CODE IS 3105 <br />TOTAL <br />7�� <br />